A Guide to COPD Diagnosis

Medically Reviewed By Adithya Cattamanchi, M.D.

Chronic obstructive pulmonary disease (COPD) refers to conditions that reduce airflow in your respiratory system. Doctors can confirm a COPD diagnosis with a physical examination, lung function tests, imaging studies, and blood work. In some cases, doctors may order other tests, such as an endurance test or spit sample analysis. Proper diagnosis is essential to creating a treatment plan for COPD.

Read on to learn more about how doctors diagnose COPD.

Overview

A paper cutout of the lungs
Yaroslav Danylchenko/Stocksy United

COPD is treatable. However, an effective treatment plan relies on correct diagnosis.

Diagnosing COPD requires knowledge of its signs and symptoms, what tests to run, and how to gauge its severity.

Learn more about the types of COPD.

Physical examination and medical history

Your doctor will begin Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source by performing a physical examination and taking a detailed history of your symptoms. It is important to provide thorough, clear information about habits such as smoking or vaping. This will help them confirm a diagnosis and provide the right care.

Your doctor will then ask questions about your symptoms. These can include questions about how long they have been present and their severity.

The signs and symptoms of COPD may include:

  • breathlessness
  • muscle loss
  • wheezing
  • needing to purse your lips to breathe
  • a “barrel-chested” appearance
  • blue coloration of the face or lips
  • “clubbing,” where the ends of the fingers appear splayed and widened
  • exercise intolerance
  • coughing with or without sputum, or mucus production

Your doctor will listen carefully to your heart and lungs for:

  • changes in heart rhythm
  • sounds in your lungs that indicate fluid
  • problems with air exchange, or wheezing

Based on these findings, they may then order testing to help determine the cause of your symptoms.

Pulmonary function tests

Pulmonary function tests (PFTs) are a group of tests that show how well Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source your lungs are functioning. Common PFTs include:

  • Spirometry: This involves inhaling deeply and rapidly followed by an exhaled blast of air over one second. You will then continue exhalation until you have breathed out all the air you can.
  • Lung volume: This test involves either breathing an inert gas or breathing against a flutter valve. It measures the difference between how much air you can inhale and how much is left after exhaling completely.
  • Diffusion capacity: This test looks at how well gasses are exchanged across the membranes of your lungs.
  • Respiratory muscle pressures: This can help your doctor assess the strength of your breathing muscles.
  • Bronchoprovocation testing: This test uses medication that narrows your airways to test how your breathing responds.
  • Fractional exhaled nitric oxide (FeNO) testing: This measures how much nitric oxide is in a sample of exhaled air. It can help Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source doctors rule out other conditions such as asthma.

Learn more about the stages of COPD.

Imaging tests

Your doctor may wish Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source to examine the structures in your lungs. They can do this using a chest X-ray or CT scan of your lungs and the surrounding tissues.

Imaging tests can help identify:

  • tumors or masses
  • enlargement of the lungs or heart
  • changes in respiratory structures

Trapped fluid or air can also appear on imaging scans. This can indicate pneumonia or damage to the air sacs.

Blood tests

Arterial blood gas testing involves obtaining a small sample of blood from an artery, usually in Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source your forearm. This helps to assess oxygen and carbon dioxide levels in your blood.

A complete blood count (CBC) may also show conditions such as infections or anemia. These could be affecting your body’s oxygen levels.

Other tests

In addition to tests specific to COPD, your doctor may use other tests to assist with a diagnosis. These can include:

  • a 6-minute walk test to measure how far you can walk on a flat, straight surface in 6 minutes
  • a sputum or spit sample test to detect infections
  • an electrocardiogram (EKG) to assess your heart’s electrical function
  • an echocardiogram, which uses ultrasound to examine your heart

In some cases, your doctor may decide to test for alpha-1 antitrypsin deficiency (AATD). This condition can affect your lungs and is a rare cause Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source of COPD.

Learn more about the causes of COPD.

Summary

A doctor may use your medical history, a physical examination, and testing to diagnose COPD. Tests such as spirometry can help them assess how well your lungs are functioning. Scheduling regular testing can help you and your doctor monitor your condition and identify patterns.

Other tests such as blood tests, sputum tests, an EKG, and an echocardiogram may help rule out other conditions.

If you believe you have COPD or are experiencing concerning symptoms, contact your doctor for an evaluation.

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Medical Reviewer: Adithya Cattamanchi, M.D.
Last Review Date: 2023 May 25
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